ObjectiveTo investigate the potential mechanism of Danggui Shaoyaosan （DSS） in ameliorating renal injury in db/db mice. MethodsThirty 8-week-old specific pathogen-free （SPF）-grade male db/db mice and six db/m mice were acclimated for one week. Urinary microalbumin and blood glucose levels were measured weekly in both db/db and db/m mice. Successful modeling was determined by significantly higher microalbuminuria in db/db mice compared to db/m mice and a fasting blood glucose ≥16.7 mmol·L^-1. The 30 db/db mice were randomly divided into five groups： the model group， the irbesartan （IBN） group， and three DSS dose groups （low-， medium-， and high-dose DSS groups， administered at 16.77， 33.54， 67.08 g·kg^-1·d^-1， respectively）. Additionally， the six db/m mice served as the normal control group. The IBN group received irbesartan at 0.025 g·kg^-1·d^-1 by gavage， while the three DSS groups received DSS at 16.77， 33.54， and 67.08 g·kg^-1·d^-1 by gavage， respectively. The normal and model groups were administered with an equivalent volume of normal saline by gavage. All interventions lasted for 8 consecutive weeks. After intervention， serum creatinine （SCr）， blood urea nitrogen （BUN）， urinary total protein （UTP）， triglyceride （TG）， and low-density lipoprotein cholesterol （LDL-C） were measured to evaluate the therapeutic efficacy of the treatments. Renal histopathological changes were observed with hematoxylin-eosin （HE） staining. Western blot was used to detect the protein expression of silencing information regulator 1 （SIRT1）， hypoxia-inducible factor-1α （HIF-1α）， very low-density lipoprotein receptor （VLDLr）， and cluster of differentiation 31 （CD31）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA levels of HIF-1α and VLDLr. Immunohistochemistry was used to observe the expression and distribution of HIF-1α and Caspase-3. ResultsCompared to the normal group， the model group showed significantly increased SCr， BUN， UTP， TG， and LDL-C. HE staining revealed glomerulosclerosis， mesangial matrix hyperplasia， capillary loop distortion and thickening， with extensive inflammatory cell infiltration. Protein expression of SIRT1 and CD31 significantly decreased （P<0.05）， while HIF-1α and VLDLr protein and mRNA levels increased （P<0.05）. Immunohistochemistry showed increased expression of HIF-1α and Caspase-3 （P<0.05）， indicating hypoxia and apoptosis in renal cells. In all treatment groups， SCr， BUN， TG， and LDL-C were significantly reduced compared to the model group （P<0.05）， and UTP was significantly improved in the medium-dose DSS group （P<0.05）. Renal tissue structure and morphology were improved， inflammatory cells were reduced， and no vascular hyaline degeneration was observed. SIRT1 and CD31 protein expression was elevated to varying degrees compared to the model group （P<0.05）， while HIF-1α and VLDLr protein and mRNA levels decreased （P<0.05）. Immunohistochemistry showed reduced expression of HIF-1α and Caspase-3 in all treatment groups （P<0.05）， with the most significant improvement observed in the IBN group and medium-dose DSS group （P<0.05）. ConclusionDSS can effectively ameliorate glomerulosclerosis and lipid deposition in db/db mice， and its mechanism may involve the SIRT1/HIF-1α/VLDLr signaling pathway.

ObjectiveTo investigate the therapeutic efficacy of Danggui Shaoyaosan （DSS） on renal injury in db/db mice and its impact on endoplasmic reticulum stress （ERS） in renal tissues. MethodsThirty 8-week-old male db/db mice and six db/m mice were acclimated for one week， after which urinary microalbumin and blood glucose levels were monitored to establish a diabetic kidney disease （DKD） model. The model mice were randomly divided into a model group， an irbesartan group， and three DSS treatment groups with different doses （16.77， 33.54， and 67.08 g·kg^-1·d^-1）. A normal group was set as control. Each group was intragastrically administered with the corresponding drugs or saline for 8 weeks. After the intervention， general conditions were observed. Serum cystatin C （Cys-C）， 24-hour urinary total protein （24 h-UTP）， 24-hour urinary microalbumin （24 h-UMA）， urinary creatinine （Ucr）， and urea nitrogen （UUN） were measured. Transmission electron microscopy （TEM） was used to observe glomerular basement membrane （GBM） and ultrastructural changes of the endoplasmic reticulum （ER） in glomerular endothelial cells. Western blot， real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， and immunohistochemistry were used to analyze renal tissue structure and the expression of GRP78， CHOP， and related markers. ResultsCompared with the normal group， the mice in the model group showed curled posture， sluggish response， poor fur condition， increased levels of Cys-C， 24 h-UTP， 24 h-UMA， and UUN （P<0.05）， while Ucr decreased （P<0.05）. The GBM was significantly thickened， with podocyte and foot process fusion. The protein expressions of GRP78， CHOP， and ATF6 were significantly upregulated （P<0.05）， the mRNA levels of GRP78 and CHOP increased （P<0.05）， and immunohistochemistry showed an enhanced GRP78 signal （P<0.05）. After treatment， the mice exhibited improved behavior， normalized GBM and podocyte structure， improved ER morphology and markedly better biochemical indicators. Western blot， Real-time PCR， and immunohistochemistry indicated that the ERS-related markers were downregulated in the DSS treatment groups （P<0.05）， suggesting alleviated ERS and improved renal function. ConclusionDSS can effectively ameliorate renal pathological damage in db/db mice， possibly by regulating ERS in glomerular endothelial cells， although the underlying signaling mechanisms require further investigation.

Objective: To investigate the effects of mandibular advancement device (MAD) upon nuclear factor κB (NF-κB), tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) in the genioglossus. Methods: Eighteen New Zealand white rabbits (male, six months old), in accordance with the random number table, were equally divided into three groups, the control group, obstructive sleep apnea hypopnea syndrome (OSAHS) group and MAD group. All animals were induced to sleep in supine position for 2 hours every morning in the next 8 weeks. The specimens of genioglossus were prepared. The relative expression of NF-κB p65 was measured with Western blotting and the mass concentration of TNF-α and IL-6 was determined with enzyme-linked immunosorbent assay. Results: The relative expressions of NF-κB p65 protein in genioglossus in the control group, OSAHS group and MAD group were 0.24±0.07, 0.44±0.08 and 0.30±0.09, respectively. The mass concentrations of TNF-α in genioglossus in the control group, OSAHS group and MAD group were (0.065±0.020), (0.097±0.018) and (0.071±0.020) μg/L, respectively. The mass concentrations of IL-6 in genioglossus in the control group, OSAHS group and MAD group were (0.063±0.013), (0.093±0.017), and (0.069±0.014) μg/L, respectively. For the above indicators, the data in OSAHS group were all significantly higher than that in MAD group and the control group (P<0.05). No significant difference was found between MAD group and the control group (P>0.05). Conclusions Treatment of OSAHS with MAD decreased the mass concentration of TNF-α and IL-6 leading to fatigue of genioglossus, reduced the activation of NF-κB and played a significant role in protecting genioglossus.

Objective To explore the MR imaging characteristics of brain tumors in infants to improve the diagnosis and early treatment.Methods Twelve infants with brain tumors (less than 1 year old),performed surgery in our hospital from April 2008 to August 2014 and proved by pathology,were collected in our study; the clinical data and MR imaging features were reviewed retrospectively.Results Among the 12 infants,4 (33％) had tumors located at the lateral ventricle,3 (25％) at the cerebral hemisphere,one (8.3％) at the pineal region,one (8.3％) at the suprasellar region,one (8.3％) at the cerebral convexity,one (8.3％) at the cerebellar hemisphere and one (8.3％) at the fourth ventricle.These tumors included immature teratoma (n=3),choroid plexus tumor (n=3),atypical teratoid/rhabdoid tumor (n=2),medulloblastoma (n=1),anaplastic ependymoma (n=1),pilomyxoidastrocytomas (n=1) and infantile fibrosarcoma (n=1).Diversity of MR imaging features was found in different types of brain tumors; tumors as immature teratoma,atypical teratoid/rhabdoid tumor and infantile fibrosarcoma showed mainly mixed signal intensity on T1-weighted images and T2-weighted images,and these tumors displayed heterogeneously enhancement at MR imaging; choroid plexus tumors and medulloblastoma showed isointenseon T1-weighted images and T2-weighted images mostly,and both had obvious enhancement; anaplastic ependymoma showed isointensity signal on T1-weighted images,slightly hyperintenseon T2-weighted images and heterogeneously enhancement; pilomyxoidastrocytomas were hypointenseon Tl-weighted images,hyperintenseon T2-weighted images and homogeneous enhancement.Conclusions Immature teratomas,choroid plexus tumors and embryonal tumors are common in infants.Supratentorial tumors are mostly found.Typical features are showed in some brian tumors,but part of atypical tumors remain challenging in diagnosis.To improve diagnostic accuracy,imaging data should be accumulated in the future.

Objective To investigate the probable pathologic basis of amido proton transfer(APT) imaging by analysing APT signal intensity and pathologic features of different grades of glioma.Methods Twenty-eight patients with glioma confirmed by postoperative pathology underwent APT scan.All the patients were divided into two groups,including 11 cases in low grade (WHO Ⅰ and Ⅱ) and 17 cases in high grade (WHO Ⅲ and Ⅳ) group.The APT rate of tumor core was measured.The specimens were processed with routine hematoxylin-eosin (HE) staining and immunohistochemistry of Ki-67 and CD34.Independent-samples t test was used to detect the difference of APT rate,cellularity,microvessel density and Ki-67 labeling indices of tumor core between low grade and high grade group.Pearson correlation analysis and multi-variable linear regression analysis were used to detect the relationship of APT rate with cellularity,microvessel density and Ki-67 labeling indices of the tumor core.Results The APT rate,cellularity and proliferation index were (2.3±0.6) ％,(9.4±2.4) ％ and (14.2±5.4) ％ in low grade group,while (3.6±0.7) ％,(18.4±4.7) ％ and (31.7±4.5) ％ in high grade group,respectively.Microvessel density was (19.0±7.4) per high-power field in low grade group and (38.9±11.3) in high grade group.There were statistical differences of the APT rate,cellularity,microvessel density and proliferation index between the low grade group and the high grade group (t=-4.94,-5.89,-5.13,and-9.28,respectively,P＜0.01).The APT rate was positive correlated with cellularity,microvessel density and proliferation index.The coefficient of correlation were 0.904,0.598,and 0.750,respectively,(P＜0.01).Multiple linear correlative analysis showed that increasing cellularity (X1),microvessel density (X2) and proliferation index (X3) were the main factors for increasing APT rate,and the correlation equation was Y=0.801 + 0.12X1-0.003X2 + 0.026X3 (F=46.437,P＜0.01,R2=0.853).Conclusions The APT signal intensity of the tumor core could reflect the pathologic features of glioma.The APT rate was positive correlated with cellularity,microvessel density and proliferation index,which indicate the higher APT rate the higher grade tumor.

Objective To explore the clinical efficacy of ALIMTA (pemetrexed disodium) plus cisplatin.Methods Patients with malignant mesothelioma were allocated to two treatment groups envelope:pemetrexed plus cisplatin (PEM-group) or cisplatin alone (DDP-group).Results A total of 64 patients were randomly assigned and evaluated.The number of patients in PEM- and DDP-group had a significant pathologic complete response were (56.25 ％ vs 21.88 ％,x2 =7.943,P ＜0.05).Progression-free survival was significantly higher in PEM-group (P ＜0.05),and 2-year survival rate was lower in DDP-group (P ＜0.05).Conclusion Pemetrexed elicit significant tumor response and delays disease progression compared with DDP alone in patients with advanced MPM.Improvement in OS is seen in this study.

To select appropriate descriptors for responses of the Health Scale of Traditional Chinese Medicine (HSTCM).

OBJECTIVE: To test the reliability and validity of Health Scale of Traditional Chinese Medicine (HSTCM) by means of questionnaires. METHODS: A cross-sectional survey was conducted at Liwan Community of Guangzhou, Old People's Home in Guangzhou and Outpatient Department of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine. A total of 652 Chinese individuals (over 18 years old) were assessed with the 88-item version of HSTCM and World Health Organization Quality of Life Measure-Abbreviated Version (WHOQOL-BREF), which were randomly delivered to them. Some socioeconomic characteristics were registered. RESULTS: A test-retest reliability (15-day interval) was found among the 76 persons who completed the questionnaires by themselves. Intra-class correlation coefficient (ICC) was 0.93. Associated 95% confidence interval (CI) was 0.89-0.96. Split-half reliability was 0.79. Inter-investigator reliability (0.93) was also good, and the ICC of HSTCM was 0.90 (95%CI 0.67-0.97). The correlation between HSTCM and WHOQOL-BREF was -0.66. The correlations of HSTCM and questionnaire deliver order, investigator, interview date and interview time were 0.06, -0.12, -0.17 and 0.20 respectively. The correlation between HSTCM and self-rated health (0.46) was greater than that between HSTCM and chronic illness (0.28). Divided by individuals with or without chronic illness, area under the ROC (receiver operator characteristic) curve for HSTCM was 0.67 (95%CI 0.63-0.71). CONCLUSION: It indicates that the HSTCM is conceptually valid with satisfactory psychometric properties and forms a basis for further applications in clinical research of traditional or integrative medicine.

Objective To obtain an accurate prevalence of dementia and Alzheimer's disease (AD) in large sample of ≥75 year old elderly living in Guangzhou city. Methods From August 1994 to December 1995, the study was conducted in Liwan District of Guangzhou, China. A two stage cluster sampling design was used to obtain a large sample. ‘Jiedao’ (resident unit in China) was the primary sampling units (PSU),‘Jumin Xiaozu’ (resident group) was the secondary sampling units (SSU). Systematic sampling and simple random sampling procedures were used for the first and second stages, respectively. The study was divided into two phases: a door to door survey of the entire sample aged ≥75 years (4 735 persons), followed by a clinical examination of suspected cases for positive and differential diagnosis. In the first phase, mini mental status examination (MMSE) was used as screening method for dementia. In the second phase, dementia and AD were clinically diagnosed according to the criteria of Diagnostic and Statistical Manual for Mental Disorders (DSM III R) , National Institute of Neurological and Communicative Disorders (NINCDS) and Stroke Alzheimer's Disease and Related Disorders Association (ADRDA). Results The sensitivity and specificity of MMSE were 0 7451 and 0 7496 respectively while the positive predictive value was 0 2251. The prevalence of dementia in individuals aged 75 years and over was 8 90%, in which male and female were found to be 2 91% and 13 11%, and that of AD was 7 49%, male and female found to be 2 01% and 11 36% respectively. The prevalence of vascular dementia (VD) was 1 16%. Of the subjects with dementia, 84 24% was diagnosed Alzheimer's disease, 13% VD, and 2 76% dementia with other causes. The proportion of AD increased obviously by every 5 years. Conclusions The prevalence of dementia in ≥ 75 year persons was lower in Guangzhou than that in Shanghai, but was higher than that in other regional studies within China. In ≥75 year male and/or poorly educated female were more easily suffered from AD. The proportion of AD in dementia was higher in this study than that in others. These figures indicated that as a screening tool for dementia MMSE need improving and should be combined with ADL and POD together.

Objective To observe the protective effect of Xuefu Zhuyu Decoction (XZD) on vascular endothelial cells (VEC) injured by the serum of blood_stasis_syndrome ( BSS) rabbits. Methods The morphological features of VEC cultured with norma l rabbit serum (Group A), BSS rabbit serum(Group B), the serum of normal rabbit medicated with XZD(Group C) and the serum of BSS rabbit medicated with XZD(Group D) were observed respectively under light microscope and electron microscope. Results Under light microscope, VEC was shrinked, intercellular space widene d and cytoplasm contained dark granules in Group B. The change of intercellular space was not obvious in Group D. Under electron microscope, pinocytotic vesicle s increased, rough endoplasmic reticulum (RER) decreased and dilated, mitochondr ia became smaller and indistinct and only a small amount of microvilli appeared on cell membrane with top expanded and merged in VEC of Group B as compared with Group A and Group C. Less RER but no dilatation and fewer microvilli without to p merged were found in VEC of Group B. Conclusion The serum of BSS rabbits c an injury normal VEC cultured in vitro and XZD exerts a certain protective effe ct on VEC injured by the serum of BSS rabbits.